Migraine, nontraditional factors likely contribute to stroke risk in young adults
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Key takeaways:
- Migraine was the most significant nontraditional risk factor for stroke among young adults.
- Other significant risk factors included thrombophilia and valvular heart disease.
Nontraditional risk factors such as migraine, valvular heart disease and thrombophilia may be linked to increased risk for stroke among younger adults, researchers reported.
Although the impact of nontraditional risk factors on stroke risk decreased with age, migraine remained the largest contributing risk factor among both men and women at any age, according to data published in Circulation: Cardiovascular Quality and Outcomes.
“We wanted to understand which risk factors were the top contributors to stroke risk among young adults,” Michelle Leppert, MD, MS, MBA, FAHA, assistant professor of neurology at the University of Colorado School of Medicine, said in a press release. “There have been many studies demonstrating the association between migraines and strokes, but to our knowledge, this study may be the first to demonstrate just how much stroke risk may be attributable to migraines.”
Nontraditional risk factors for stroke
Using data from the Colorado All Payer Claims Database from 2012 to 2019, Leppert and colleagues identified 2,618 index stroke events in young adults aged 18 to 55 years (52% women; 73% with ischemic stroke) and matched them 1:3 to stroke-free controls. The prevalence of nontraditional risk factors during participants’ pre-stroke period was compared between the two groups.
Nontraditional risk factors of interest included migraine, malignancy, HIV, hepatitis, thrombophilia, autoimmune disease, vasculitis, sickle cell disease, valvular heart disease and renal failure.
The proportion of participants with one or more pre-stroke nontraditional risk factors was greater among those with a history of stroke compared with matched controls, regardless of sex (P < .0001).
The strength of the association between nontraditional risk factors and the population-attributable risk for stroke declined with age, but the researchers reported that migraine was the most significant nontraditional risk factor, with a population-attributable risk of 20.1% in men and 34.5% in women aged 18 to 35 years.
Following migraine, other nontraditional risk factors tied to increased population attributable stroke risk in men included renal failure and thrombophilia (P for all < .05). Valvular heart disease was also a nontraditional risk factor, but only among men aged 18 to 44 years (P for all < .05).
Renal failure and thrombophilia were also nontraditional risk factors for stroke among women aged 35 to 55 years (P for all < .05); however, only among women aged 18 to 34 years were valvular heart disease and autoimmune disease risk factors (P for all < .05).
Do not ‘only focus on traditional risk factors’
“These findings are significant because most of our attention has been focused on traditional risk factors,” Leppert said in the release. “We should not ignore nontraditional stroke risk factors and only focus on traditional risk factors; both are important to the development of strokes among young people.
“In fact, the younger they are at the time of stroke, the more likely their stroke is due to a nontraditional risk factor,” she said. “We need to better understand the underlying mechanisms of these nontraditional risk factors to develop targeted interventions.”
Reference:
- Young adults with migraine, other nontraditional risk factors may have higher stroke risk. https://newsroom.heart.org/news/young-adults-with-migraine-other-nontraditional-risk-factors-may-have-higher-stroke-risk. Published March 26, 2024. Accessed March 26, 2024.
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